Doctors Strike: The Aftermath

Doctors’ Strike: The Aftermath



It has been two months since one of the largest strike by doctors shook the province of Punjab. It all started with the closure of Outdoor Patient Departments (OPDs) in all major hospitals across the province as a gesture to protest against the attitude of the Government of Punjab in provision of a better service structure for Doctors. It was a move designed to be of minimal impact because only ‘stable’ patients visit OPDs and there was no threat to patients’ lives. Last year similar protests by doctors led to a commitment by the Chief Minister to provide a new service structure and committees were formed to pave the way for formulating an acceptable formula. The closure of OPDs happened after one year of useless meetings with the representatives of Punjab government.

Last year, government was unable to control doctors and the chaos led to loss of many precious lives and ended with a truce. This time around, Khwaja Salman Rafiq (brother of Saad Rafiq and Special Assistant to Chief Minister on matters of Health) was designated the responsibility to ‘deal’ with the situation. Punjab Government started giving half-page advertisements in all major newspapers stating it had already done too much for the doctors and that doctors were essentially getting too big for their own boots. An estimated Rs. 1.6 million per day was given to newspapers and Rs. 450 million of public money was spent on advertising by ‘Khadim e Aala’s government. In addition, Essential Services Act was enforced by the govt, making it mandatory for doctors to do their OPD duties or else receive legal proceedings.

On 1^st July, 2012(after 21 days of OPD closure), a police raid was conducted at Doctors’ Hostel, Services hospital Lahore, resulting in arrest of numerous doctors. The same night, hundreds of other doctors were arrested from their homes. There was another raid at Doctors’ Hostel, King Edward Medical College on the night of 2^nd July. A total of 360 doctors were kept in Jails including Kot Lakhpat, Attock and Mianwali for four days. As a result of all this, emergency services were withdrawn from all major hospitals and any negotiations were made subject to release of all the doctors.

I want to recount some of the ‘stunts’ pulled out by the government during all this, apart from ‘Advertisement’ money from the public exchequer.  

1. ‘Medical Martial Law’:

As a ‘contingency’ plan during the closure of OPDs, Punjab government requested help of Army Medical Corps (AMC) to decrease patient overload. This was an unprecedented act of desperateness and expediency shown by the big-wigs of Punjab Government. This ‘experiment’ did not work out though. It failed miserably. Senior Doctors said it on record that the Army doctors were not trained to deal with such situations. Additionally, those doctors were paid Rs 2000 per hour of duty and special police contingents were employed outside hospitals where the Army doctors worked. For comparison, government of Punjab was paying Rs 800 per day to junior doctors and Rs 1400 per day to seniors whose places the Army doctors took for few days.
There were reports of those Army doctors misbehaving with the senior doctors and the ‘flexible’ duty hours practiced by our 'Jarri Jawans'. At the start of the Strike, Zaid Hamid's Baloongra's alleged that YDA punjab is actually “NGO funded Young Animal Association” and they work for money, not for saving lives. The 'Brave' Army Doctors that came 'to the rescue' didn't work for free though. This is the characteristic selective Amnesia practiced by Qibla Zaid Hamid and his followers.  For the Record, only 200 Army Doctors were deployed.!!!

2. The PCO Doctors

During the strike by Junior Doctors, Government hired around 500 new doctors (in place of around 5000 doctors) on ad-hoc basis. Those individuals are known these days as ‘PCO doctors’. They mostly include foreign graduates (who can’t normally get jobs at Government Hospitals as per orders of Chief Minister) and people who could not get job in ordinary circumstances. Some people, who had not practiced medicine for more than 10 years, joined the service just to get a paid Job. Chief Minister Punjab is fond of parroting the mantra of ‘Merit’ but these blatantly out-of-merit inductions did not gain his attention. All these people were hired against the rules and on ‘paid seats’ while more than 50% doctors work in government sector without getting any pay.

3. The legal Front

Apart from hundreds of doctors arrested without any justification, four doctors from Mayo Hospital were charged with Murder of a child that died in the Pediatrics Ward on the night of 1^st July, 2012. The Strike was also challenged in court and it resulted in involvement of Lahore High Court in the matter. The court ordered to release all doctors who were arrested without any legal reason and granted bail to the four doctors alleged to be involved in the Murder. It was further ordered that matters pertaining to Service Structure should be solved amicably by the Punjab Government.

4. Lies and Damn Lies
Throughout the strikes, there was a continuous propaganda mongering done against the ‘Cream of Nation’. Government Officials lied on Television programs and press-conferences about doctors being greedy, selfish, hooligans etc. The entire Advertisements campaign consisted of Jacked up figures that were used to fool people.

The Aftermath

On 2^nd August, one month after the strike, a follow-up meeting was called up by Young Doctors Association in Services Hospital Lahore. Dr. Amir Bandesha, member of the committee delibrating the future service structure, explained at length about the proposed changes to the existing structure and the points on which a consensus had been reached between Punjab Govt and YDAP. ‘PCO Doctors’ are still working in the hospitals despite resumption of services by young doctors and it is the demand of YDAP to transfer them to DHQs and RHCs.  After the meeting of general council of Young Doctors Association on 29^th August, 2012, province-wide protests were held on 5^th of September to exert further pressure on the Govt to solve our problems. Committees have failed to provide us any relief and even the Lahore High Court has been unable to enforce the writ of law. Another Protest/Dharna is planned for 19^th September and a March to the CM Punjab House after that. Is another showdown between doctors and State on the way?

Brain Drain-1

(Published in The Friday Times on 14-09-2012)

33,703 candidates appeared in the entry test for medical colleges in Punjab last year, competing for 5,271 seats in 40 public and private medical and dental colleges. Nearly 3,500 seats are available in 15 medical and 3 dental colleges in the public sector, while 1,850 seats are available in private medical and dental colleges. This suggests that the top 3,000 candidates would be able to secure admission in the public sector and around 2,000 more will get admission in Private Medical Institutes.

These figures raise the question: What about the rest of the 28,000 students who passed FSc (Pre-Medical) with more than 60% marks but were deemed not good enough to get admission into a medical college, either due to merit or financial issues, as Private Medical Colleges charge almost half a million rupees every year only in tuition fee? 

As the saying goes: where there is a will, there is a way. And that's another way of saying that students who want to become doctors should make use of opportunities to study medicine abroad.

Medical education in developed countries such as USA,UK, Australia and Canada is much more expensive than in Pakistan, so the options for most Pakistani students are either China or the ex-Soviet states such as Kazakhstan or Kyrgyzstan. Medical Education in these countries is imparted in English, so there's no worry about language barriers. Browse through any English or Urdu daily in Pakistan and you'll see advertisements for institutes in these countries. 

This trend of going abroad to get a degree in medicine started in the 1990s when Central Asian colleges became a destination for students who lacked good marks. It should be pointed out that the minimum eligibility criteria for the Medical Colleges Admission Test (MCAT) is 60% marks in FSc. Initially, students with marks as low as 35-40% were able to secure admissions in Central Asian colleges. It was a dream come true, a shortcut bypassing the system in Pakistan. Chinese medical institutes offering medical courses in English started in the last decade.

At present, around 2,000 Pakistanis are studying medicine in various medical schools across Kyrgyzstan. According to the United Nations, a July 2006 survey of medical students at nine institutions in Kyrgyzstan rated their level of knowledge between 2 and 2.6 on a five-point scale. In China, there are 6  medical colleges and 1 dental college recognized by the Pakistan Medical and Dental Council (PMDC). Each of these medical schools has around 150-200 Pakistani students per session. Nine hundred Pakistani medical students are presently studying medicine in Cuba on scholarships awarded by the Cuban government after the 2005 earthquake. But PMDC does not recognize Cuba's medical colleges and the living conditions of our students there are pathetic. Around 100 Pakistani students are studying medicine in Bangladesh. Vulnerable students are duped into some of these places with fancy titles like 'WHO Recognized Medical Institute'. The fact remains that WHO (World Health Organization) "has no authority to grant any form of recognition or accreditation to schools of medicine or other training institutions. Such a procedure remains the exclusive prerogative of the national government concerned." (This is WHO's own clarification.) The Pakistani state has done little to stall this "business". Pakistan's embassies in the respective countries do not own the students if they face any difficulties regarding the whole process. In Cuba, students live 15 Kilometres away from the city in which their college is located. In China, many universities which are not officially recognized enroll students using paid agents in Pakistan. Every admission gets the agent a fixed amount of money and the unsuspecting student can't get out of this maze easily. The big problem facing Pakistan's health system is the influx of these Foreign Educated Doctors and their integration into the system. These medical graduates are not at par with their counterparts from Pakistan-based institutes and that creates a chasm in their ability levels. In almost all the foreign universities, clinical training, the backbone of undergraduate programs, is seriously lacking because of obvious language constraints. You can teach students in English but you can't teach them all the required nuances of the local language in such a short period of time. Without the necessary knowledge of the local language, how can anyone get a good medical history from a patient? (Around 70% of clinical diagnoses are based on a patient's medical history.)  PMDC has made it compulsory for all international medical graduates to pass a specially designed test to practice medicine in Pakistan. This is the only intervention done on a governmental level for these doctors. A lot of those who can't pass the test end up working for private hospitals, as they can't get jobs in the public sector. This alternate pathway for medical education is going to flood Pakistan with a lot of substandard doctors very soon.

The Adventures of "Aabpara Boys"

THE ADVENTURES OF AAB PARA BOYS



Mr. Hamid Meer, who has been peddling the case of the Pakistani Intelligence Agencies for most of his career, has finally gotten to his senses and is vying for a cause in which he is supported by the progressive forces in Pakistan. He has been questioning the authority of the Deep State in the last few months. This has not gone well with some of the infamous “Aabpara Boys” and no wonder they have started taking him on, using social media networks.


After the drama of holding the government accountable day in and day out, it seems that the top TV anchors of Pakistan are out to get each other. If this debate was about principles, public interest or setting the facts correct, than it would be of immense value. However, the new Tamasha engineered by one self-styled judge and prosecutor, is trying to defame an experienced reporter/ TV Journalist. The allegations are one-sided, aired without evidence.

What is the fault of Hamid Meer? 
(Please consider that I do not belong to the Hamid Meer Fan Club)

All the “Aabpara boys” are ganging up on Hamid Meer because at a critical juncture, Hamid Meer switched sides and backed the elected over the un elected, rights of balochs and missing persons, over the excesses of the Deep State.
Hamid Meer needs to be supported at this crucial time of Pakistan’s history and we hope that he is not brow beaten into siding with his former friends and mentors!

Thanks to the the vibrant blogosphere, the known faux pas and lack of professionalism by supposedly experienced journalists have been exposed in Public. Following is a brief summary of the “Kartoot” of the “Pasha Boys” compiled by diligent blog, Pakistan Media Watch.

1. Mubashar Luqman
   
   *After he did a show with Mukhtaran Mai, Blogger Sana Saleem wrote an open letter to Mr.Mubashar Luqman, stating,“It is people like you and attitudes such as yours that feed the vicious cycle of prejudice against rape victims, making the fight for justice harder. It is appalling that you would allow your guests to hurl allegations on Mai, call her rape fictitious without any substantial evidence and in the presence of a Supreme Court judgment.It was appalling to witness you cross-question Mai, while ignoring the plight of hundreds of women who have suffered at the hands of these illegal jirgas. Not once in your programme did you mention the innumerous decisions made by these notorious jirgas, from burying women alive to feeding them to the dogs.  Your attitude in the program and your approach to the case is an insult to the plight of the 2,903 women who were raped in 2010 alone and may never get justice.”
   
   
   *Mubashar Luqman tried to spread the news of “Bird Flu epidemic” in Punjab, which was NEVER confirmed and ended up causing losses to so many innocent poultry farmers.
   *Pakistan Media Watch, on 15^th Januart 2012,  wrote the following about Mubashar luqman,
   “A few months ago we warned Shahid Masood and Azeem Mian that Mubasher Lucman had entered the race for PTI Media Advisor and taken the contest to a whole new level. It seems that with the government’s troubles and PTI’s rising popularity, Mr lucman has stepped up his campaign using a popular PTI format – social media.
   Mubasher Lucman is “not in politics” in so far as he has never been elected by anyone to anything. But he has also clearly inserted himself into politics by actively campaigning for his selected favourites and terming anyone he disagrees with (or just doesn’t like) as “corrupt”. That’s what political operatives do. It’s not journalism.”
   
   *After the Bhoja Air Crash Tragedy, Mubashar Luqman’s conduct was less than exempelary,
   “The most gruesome, however, was the way some elements of the media jumped on the opportunity to turn the tragedy into an opportunity for cheap political point scoring. Dunya TV anchor Mubasher Lucman bizarrely criticised Rehman Malik for quickly responding to the crash “when he is not asked”, as if the Interior Minister should wait to be asked before responding to such a tragedy.”
   

*There is still no explanation on how Mubashir Luqman’s twitter followers increased from 6092 followers to 103,595 followers overnight?

*To top this behaviour up, Mubashar Luqman’s allegations in Noor’s Morning Show against Najam Sethi were horrible and out of the context. This issue was discussed in detail here.

2.Shaheen Sehbai:-
Regarding the ‘exploits’ of Mr Shaheen Sehbai,

*On 23^rd March, 2011, Pakistan Media Watch wrote,
“In his latest column for The News (Jang Group), Shaheen Sehbai holds a ‘funhouse mirror’ to the president’s speech and comes up with a curious 10-point list of what the president did not say in his address to the National Assembly on Tuesday. Sehbai’s column is purely editorial, though it is labeled as ‘News Analysis’ so that it can appear on the front page and not properly the opinion page.
This 10-point list of Shaheen Sehbai is not ‘analysis’ it is political attacks only. And these attacks are not even based in reality, but it Shaheen Sehbai’s own willful ignoring of facts. Just because you label something ‘analysis’ does not make it so. This column could have been used to provide analysis of some of the serious issues facing the nation and made some recommendations for how the government and opposition leaders can work together to pass solutions for the good of the country. Instead, readers of The News were presented with yet another political attack consisting of misleading accusations devoid of context and reason.”


*It was reported on 5th February 2011,
“In response to Jang Group’s publishing the internet hoax of president Zardari secretly marrying a Pakistani-American doctor, the Zardari family has sent legal notice to Jang Group specifically Mir Shakil-ur-Rahman and Shaheen Sehbai demanding immediate retraction and apology otherwise they will face legal action
“…for libel, malicious publication and intentional infliction of emotional distress in all jurisdictions where your newspaper is published, as well as any jurisdiction in which your paper has assets. This lawsuit will seek in excess of $100 million, which the Bhutto-Zardari family would donate to the victims of the 2010 floods in Pakistan."

*On 3^rd April 2011, Pakistan Media Watch opined,
“Shaheen Sehbai’s front page story included no facts or investigative reporting, and was nothing but a baseless attack on the government in what appears to be another thinly veiled attempt to incite a war between the executive and judiciary.
In fact, Shaheen Sehbai does not even bother pretending to have ‘informed sources’, offering only his own insults and accusations. This is considered reporting by Jang Group?”


* On 15 October 2011, we came to know,
“Shaheen Sehbai has been suffering humiliation for over three years now since Asif Zardari was elected to the presidency and not immediately booted out, as Sehbai incorrectly predicted. During these years, he has penned a number of pieces based in little more than rumor and speculation, and that appear to be aimed at pitting the civilians and the military against each other. His blatantly selective reading of Mansoor Ijaz’s opinion piece for FT is only the latest strike in this sad campaign.”

*On 6^th March 2012, it was reported,
“Actually, Sehbai’s latest conspiracy is just the latest version of Shaheen Sehbai’s worn out anti-Zardari script. If you remember, when the present government was first elected, Shaheen Sehbai was part of a vocal group of Zardari haters whose personal animosity for the president was so strong that they declared the government a failure before it even began. With each passing event, the Zardari Haters Club predicted the imminent fall of the government, and each time they were proven wrong.”

*On 13^th March, 2012, the old links between Shaheen Sehbai and Manzoor Ijaz were traced,
“Shaheen Sehbai was one of the the first Pakistani journalists to promote Ijaz – not after the famous Financial Times op-ed, but over a decade beforehand. While he was Dawn‘s Washington correspondent in the mid-1990s, Shaheen Sehbai wrote several stories promoting the American businessman. In 1995, Sehbai filed a story, ‘Dateline Washington : A blueprint Pakistan cannot ignore’ that described Mansoor Ijaz as the manager of a billion dollar investment firm who is the secret hand writing US policy. Actually, Sehabi’s description from 1995 sounds strangely familiar.”


Hamain Sab hai yaad Zara Zara, Tumhain Yaad ho kay na Yaad ho.

Madam Ayesha Siddiqa does not agree with this article, but I rest my case.

P.S This post has not been "sponsored" in any way by Mr. Najam Sethi. In your face, ML.